新生儿交换输血术对新生儿血清补体C3、C4的影响

The effect of exchange transfusion on serum complement C3,C4 in newborns

目的:通过对新生儿高胆红素血症(简称高胆)患儿进行交换输血治疗的前后分别测定血清补体C3、C4,评估高胆患儿的补体系统免疫状态和换血后的变化情况,了解交换输血术对新生儿血清补体的影响。方法:对62例新生儿高胆患儿进行交换输血治疗,治疗的前后分别测定血中补体(C3、C4),并将高胆患儿依据病因分成ABO溶血病组、Rh溶血病组、脓毒症组、其他组4组进行分析。结果:(1)换血术前:补体C3、C4的水平各组比较差异无统计学意义。(2)换血术后:补体C3:脓毒症组的水平较其他3组高,差异均有统计学意义,其余3组间比较差异无统计学意义;补体C4:各组间的水平比较差异无统计学意义。(3)换血术后与术前比较:C3:各组均数在换血术后均有升高,但只有ABO溶血病组术后的改变差异有统计学意义;C4:ABO、Rh溶血病组较术前稍升高,其余两组稍降低,各组间差值比较差异无统计学意义;术后较术前各组变化值比较差异无统计学意义。结论:(1)新生儿高胆患儿血中补体C3、C4水平无明显差异,但水平偏低;(2)换血术能提升脓毒症患儿血中补体C3的水平,有助于免疫力增强;(3)换血术对补体C4的影响较小;(4)换血术对高胆新生儿补体免疫系统是有益的、安全的。

Objective To detect the levels of serum complement C3, C4 separately before and after the exchange blood transfusion treatment to the newborns with hyperbilirubinemia, then to evaluate the complement system immune status and the change situation after exchange blood transfusion and understand influence of exchange blood transfusion technique to the newborn serum complement. Methods Carrying out the exchange blood transfusion treatment to 62 newborns with hyperbilirubinemia and detecting the level of serum complement C3, C4, then all the cases were divided into four groups according to different etiologies： ABO hemolysis group, Rh hemolysis group, sepsis group and other etiology group. Results （1）Before exchange transfusion： it had non- statistic significance in each group of complement C3, C4 level. （2）After exchange transfusion, complement C3 in sepsis group was significant higher than the other three groups, while there were non-statistic significance among the other three groups. The level of complement C4 was non-statistic difference among the four groups. （3）The comparison before and after exchange transfusion： the mean values of C3 in each group elevated after exchange transfusion, in which the difference in ABO hematolysis group had statistic significance. The mean values of C4 in ABO and Rh hemolysis group elevated slightly after exchange transfusion, while the other two groups reduced slightly. The difference among four groups had non-statistic significance ; it also had no significant difference of C4 between before and after exchange transfusion in four groups. Conclusions （ 1 ）The complement C3, C4 level were low and had no difference in the newborns with hyperbilirubinemia. （2）Exchange transfusion can promote the level of complement C3 in blood of septic newborn and is helpful to enhance the immunity. （3）The influence of exchange transfusion to the complement C4 is unobvious. （4）The exchange transfusion is beneficial and safe to complement immune system of newborns with hyperbilirubinemia.